Forms Compendium

Galveston Bay Area Chapter Master Naturalist Program

FORMS COMPENDIUM Table of Contents

Volunteer Service Pre-Approval Request Form Advanced Training Pre-Approval Request Form Membership Transfer Form Dues Payment Form, Hold Harmless Agreement Image Use Authorization Form Project Tracker Form Texas Cooperative Extension – Youth Protection Standards Program Form Ballot Template Hours Reporting Form

GALVESTON BAY AREA CHAPTER VOLUNTEER SERVICE PRE-APPROVAL REQUEST

All volunteer service, unless executed through programs or projects pre-approved by the Chapter Board of Directors, must be submitted in writing to the Volunteer Service Director and receive approval before hours are accumulated. Programs and projects presented by Chapter sponsors and partners are automatically approved it they meet the criteria of the Galveston Bay Area Chapter.

Name: ______

E-Mail Address: ______Phone #: ______

Program Title: ______

Training Location: ______

Program Date: ______

Organization Name & Phone #: ______

Instructor Name & Title: ______

Program Summary: ______

______

______

Send Pre-Approval Request To: Date of Request: ______Texas Cooperative Extension 5115 Highway 3 Dickinson, TX 77539-6831 Attn: GBAC-TMN or e-mail: Volunteer Service Director ------

Pre-Approved or Denied by:

______Date:______

______Date:______

Reason for Denial: ______

______

------

Volunteer/Advanced Training Chairperson’s Notes

Revised August 7, 2008

GALVESTON BAY AREA CHAPTER ADVANCED TRAINING PRE-APPROVAL REQUEST

All advanced training and volunteer service, unless executed through programs or projects pre-approved by the Chapter Board of Directors, must be submitted in writing to the Chapter Training Director and receive approval before hours are accumulated. Programs and projects presented by Chapter sponsors and partners are automatically approved it they meet the criteria of the Galveston Bay Area Chapter.

Name: ______

E-Mail Address: ______Phone #: ______

Program Title: ______

Training Location: ______

Program Date: ______

Organization Name & Phone #: ______

Instructor Name & Title: ______

Program Summary: ______

______

______

Send Pre-Approval Request To: Date of Request: ______Texas Cooperative Extension 5115 Highway 3 Dickinson, TX 77539-6831 Attn: GBAC-TMN or e-mail: Chapter Training Director ------

Pre-Approved or Denied by:

______Date:______

______Date:______

Reason for Denial: ______

______

------

Volunteer/Advanced Training Chairperson’s Notes

Revised April 29, 2008

Galveston Bay Area Chapter

Membership Transfer Form

Name ______Address______

City ______TX ZIP______Birthday _____/_____ Month Day

E-Mail Address ______

Home Phone ______Cell Phone ______

Date of Certification ¾ Are you a Certified Texas Master Naturalist? _____Yes ______¾ Are you currently a member of a Texas Master Naturalist Chapter? _____Yes ¾ Are you transferring from another State? _____Yes ¾ If Yes, please complete Chapter Name ______

Address ______

City, ST, Zip ______

State Requirement: The transferee brings a letter from the old chapter certifying that the transferee is a member in good standing, which includes paid dues. In addition, the letter should certify the number of volunteer service hours and advanced training hours, training or Certification that have been accrued during the current year.

Complete and Sign the Chapter Dues/Hold Harmless Agreement/Release Image and/or Voice Form F Galveston Bay Area Chapter Annual Membership dues have been assessed at $20.00 per individual and due in January. F Complete and Sign Hold Harmless Agreement F Release for Use of Image and/or Voice Agreement F Texas Cooperative Extension Youth Protection Standards Program Form Return Completed Forms to: Copy to: Terry Jackson, Membership Chairperson Julie Massey, Advisor Galveston Bay Area – TMN Galveston Bay Area - TMN 5528 Ave S 5115 Hwy 3 Galveston, TX 77561 Dickinson, TX 77539 Phone: 409-740-0847 281-534-3413, ext. 22

Revised April 29, 2008 Page 1 of 2

Galveston Bay Area Chapter

Chapter Dues Hold Harmless Agreement Release Image and/or Voice

Please complete for Membership Directory NAME______Address______City______ZIP______Phone Home (___)______Email______Work (___)______Birthday-Month______Day ______Cell (___)______

TMN Certificate Date ______Re-Certification Date ______Transferred from another Chapter? Yes ___ Chapter Name ______

Dues $20.00 Date Paid ______Dues are Payable by January 31st.

Check #______Cash/Receipt# ______

Make checks payable to: Galveston Bay Area Chaptern(GBAC-TMN) ------Hold Harmless Agreement

Each member and any participating volunteer understands that in consideration of being accepted as a participant in the Texas Master Naturalist™ volunteer program (“program”), hereby releases, discharges, and agrees to hold harmless the program and its sponsoring state agencies, their agents, employees, officers and successors from and against the program and sponsoring state agencies, their successors, employees, or officers for all personal injuries (including death), known and unknown or damage to property caused by or arising out of activities performed under the Texas Master Naturalist™ program. I hereby accept the Hold Harmless Agreement as stated above.

______Member Signature Date ------

Revised April 29, 2008 Page 2 of 2

GALVESTON BAY AREA CHAPTER RELEASE FOR USE OF IMAGE AND/OR VOICE

______Yes, I hereby authorize the Galveston Bay Area Chapter of the Master Naturalist Program, or its assignees, in partnership with the Texas Parks and Wildlife Department and the Texas Cooperative Extension, to record and photograph my image and/or voice for use in research, education, and promotional programs.

I understand and agree that these audio, video, digital, film, and/or print images may be edited, duplicated, distributed with or without charge, reproduced, broadcast and/or reformatted in any form and manner without the payment of fees, in perpetuity.

_____ No, I do not authorize the use of my image and/or voice

Revised April 29, 2008 Page 3 of 2

Galveston Bay Area Master Naturalist Project Planning Tracker

Project Title ______Date ____/_____/_____ Project Location ______Time______# of Participants ______

Hours Apply Volunteer Service_____ Advanced Training _____ (Show number of hours for event) Hours Hours

Project Leader/Contact ______Home Phone ______E Mail ______Cell Phone ______

Description of Project (Who will benefit? What is the purpose of project? Does it meet GBAC-MN guidelines?)

Completed Key Dates Action Delegated To Date

Key Personnel Phone / E Mail Address Speaker / Speaker Fee Name of Speaker Yes $______Photographer Name of Photographer Yes Facility Admission Fee Name of Facility / Contact Person $______

Revised April 29, 2008 Page 1 of 2

Project To-Do List Member(s) Responsible Member Chapter Est. Actual Description Name/Phone/E Mail Provides Provides Cost Cost Transportation Yes Yes  Carpool? No No  Bus / Van? Yes Yes Meals / Drinks (Please show Details) No No

Other Expenses (Please show details)

Comments:______Please attach: Send to: 1. Attendance Sheet Membership Chairman 2. Project Coordinator’s Summary Chapter Historian

Revised April 29, 2008 Page 2 of 2

Revised April 29, 2008

Galveston Bay Area Chapter

Ballot Template December xxxx

Officer Election (Please circle one candidate for each office)

President Mickey Mouse Donald Duck Minnie Mouse

Vice President Underdog Polly Purebred Simon Barsinister

Secretary Bugs Bunny Wile E Coyote Road Runner

Treasurer Yogi Bear Boo Boo Ranger Smith

Director Recommendations (Please vote for one candidate for each office)

Membership Fred Flintstone Barney Rubble Mr. Slate

Chapter Training George Jetson Mr. Spacely Astro the Dog

Volunteer Service Boris Badenov Fearless Leader Natasha Fatale

Other Matters

Galveston Bay Area Master Naturalist Volunteer Advanced Year Direct Indirect E Mail Report to IMPORTANT REMINDER Activity Form Service Training 2009 - - - - [email protected] PLEASE ENTER OUTREACH AND EDUCATION DATA. January 1, 2009 thru December 31, 2009 2008 Mail Form to: THANK YOU 2007 Terry Jackson DIRECT: Number of people educated actual hands-on, 2006 5528 Avenue S classroom instruction 2005 Galveston, TX 77551 Phone 409-740-0847 INDIRECT: Number of people educated through booths, Name 2004 Annual Certification and/or ReCertification displays, mailouts, etc. 2003 Requirements 2002 40 Hours Volunteer Service (VS) Totals - - - - 8 Hours Advanced Training (AT) TPWD, Local Special Total Orgs., Events, Restor- Youth Volunteer Date Wetland Monitor- Nature Approved Shows, MN Class GBAC Newsletter ation Education Travel Service (mm/dd/yy) Project Site Restor-ation ing Centers Public Field Direct Indirect Training, Board Web Site (Carbide i.e. Morgan, Time Hours or Date Location (ABNC, (SWIM Animals (ABNC, Service Days i.e. Advanced Outreach Outreach Brief Description of Event or Activity Treasures and/or Photos Park Rosenberg Use .25, Column Range TCPP, GISP,etc Shoreacres Plants Anahuac Parks Feather Training & & of Bay Committee Member Prairie Camp Wild .50, .75, Auto (mm/dd- NOT CITY) Heron Water Refuge, (GISP, Fest, Bay Education Education Wksp Meetings Records TCPP Angler Edu, or 1 hr. Calculates dd/yy) WWGC) Weather etc.) Clear Creek Day, Reitan Jr. MN Do Not NP, Beach Point) Enter Data Challenger Day Park) 2009 Total Hours (Auto Calculates) ------

Created by Terry Jackson Member Record Form 2009 1 of 1 Updated 2/4/2009 Name